Terapia endocrina para el cáncer de MAMA RH+/HER2- avanzado/metastásico en Argentina: Análisis retrospectivo de los patrones de tratamiento durante los últimos 25 años

Ignacio Robledo Salas; Florencia Guerra; Lorena Boixadera; María Mateo; Pablo Cresta Morgado; Andrea Aguilar; Valeria Cáceres

doi:10.56969/oc.v27i1.4

Autores/as

Ignacio Robledo Salas Instituto de Oncología Ángel H. Roffo, Universidad de Buenos Aires
Florencia Guerra Instituto de Oncología Ángel H. Roffo, Universidad de Buenos Aires
Lorena Boixadera Instituto de Oncología Ángel H. Roffo, Universidad de Buenos Aires
María Mateo Instituto de Oncología Ángel H. Roffo, Universidad de Buenos Aires
Pablo Cresta Morgado Instituto de Oncología Ángel H. Roffo, Universidad de Buenos Aires
Andrea Aguilar Instituto de Oncología Ángel H. Roffo, Universidad de Buenos Aires
Valeria Cáceres Instituto de Oncología Ángel H. Roffo, Universidad de Buenos Aires

DOI:

https://doi.org/10.56969/oc.v27i1.4

Palabras clave:

cáncer de mama metástasico, receptor hormonal, terapia endocrina, quimioterapia, metastasic breast cancer, hormone receptor, endocrine therapy, chemotherapy

Resumen

La terapia endocrina (TE) es el estándar de tratamiento del cáncer de mama metastásico (CMM) RH+/HER2-. Sin embargo, los datos de la práctica clínica demuestran que una alta proporción de pacientes son tratados con quimioterapia (QT). Nuestro objetivo fue obtener información del mundo real sobre el tratamiento en pacientes con cáncer de mama metastásico (CMM) luminal, comparando el uso de TE versus QT en los últimos 25 años. Para el análisis se establecieron cuatro cohortes de tiempo: (A: 1994-1999, B: 2000- 2009, C: 2010-2015 y D: 2016-2020). La TE fue el tratamiento de primera línea en el 67%; 70% y 87% de los pacientes en las cohortes B, C y D respectivamente (ajustado por comparaciones múltiples, p=0.0024). La proporción de pacientes que recibieron QT en primera línea comenzó a disminuir en más del 30% en la cohorte B (2000- 2009) a menos del 15% en la cohorte D (2016- 2020) debido a la inclusión de los inhibidores de quinasas dependientes de ciclinas 4/6 (CDKi). En el análisis multivariado de la cohorte B y C, los factores asociados con un menor uso de QT fueron las metástasis óseas exclusivas, menos de 2 sitios metastásicos y un bajo KI 67%. Los patrones de tratamiento para CMM RH+/HER2- han cambiado sustancialmente en los últimos años a partir del advenimiento de los CDKi en la cohorte D. Nuestros datos informan una disminución del porcentaje de pacientes tratadas con QT en primera línea en la vida real.

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